Organization Active NPI

Richard M Lieberman, MD, PC

  • Pediatric Urology Physician
  • Allentown, PA
National Provider Identifier
1699891564
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
License
MD030973E Issued in PA
Legal business name
RICHARD M LIEBERMAN, MD, PC
Practice address
1259 S Cedar Crest Blvd
235
Allentown, PA 18103-6372
Phone
(610) 770-9700
Fax
(610) 770-1791
NPI assigned
Mar 22, 2007
Last updated
Oct 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Richard Michael Lieberman, MD
Title
Physician
Phone
(610) 770-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2088P0231X MD030973E PA Primary

Addresses

Primary practice location

1259 S Cedar Crest Blvd
235
Allentown, PA 18103-6372

Mailing address

1259 S Cedar Crest Blvd
235
Allentown, PA 18103-6372
Phone (610) 770-9700

Other identifiers 3

IdentifierTypeStateIssuer
02352700OtherPACAPITAL BLUE CROSS
1025309MedicaidPA
94789OtherPAAETNA

National Provider Directory

National Provider Directory

Locations

1259 S Cedar Crest Blvd
#235
Allentown, PA 18103
Phone (610) 770-9700

1259 S Cedar Crest Blvd
Ste 235
Allentown, PA 18103
Phone (610) 770-9700

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1699891564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 S CEDAR CREST BLVD",
            "address_2": "235",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036372",
            "telephone_number": "610-770-9700",
            "fax_number": "610-770-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 S CEDAR CREST BLVD",
            "address_2": "235",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036372",
            "telephone_number": "610-770-9700",
            "fax_number": "610-770-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD M LIEBERMAN, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "610-770-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": "PA",
            "license": "MD030973E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02352700",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025309",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "94789",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.